维持性血液透析患者精神心理状况分析及其与血清色氨酸水平的相关性研究  

Analysis on the mental and psychological analysis of patients with maintenance hemodialysis and their correlation with serum tryptophan levels

作　　者：徐道祥 史惠敏 林小东 

机构地区：[1]浙江省温州市第七人民医院心理科,浙江温州325005

出　　处：《中国现代医生》2018年第2期1-3,11,共4页China Modern Doctor

基　　金：浙江省温州市科技计划经费自筹项目(Y20170387)

摘　　要：目的研究维持性血液透析患者精神心理状况及其与血清色氨酸水平的相关性。方法选取我院2015年3月~2016年12月122例进行维持性血液透析的患者及115例健康志愿者为研究对象,将122例进行维持性血液透析的患者纳入研究组,115例健康志愿者纳入对照组。检测两组焦虑和抑郁等心理状况及血清色氨酸水平。结果 (1)研究组患者焦虑阳性发生率和抑郁阳性发生率均高于对照组(P<0.05)。(2)抑郁组患者IL-6、犬尿氨酸高于非抑郁组患者,抑郁组患者Trp、HGB低于非抑郁组患者(P<0.05)。(3)焦虑组患者Scr、BUN高于非焦虑组患者,焦虑组患者血钙、血磷低于非焦虑组患者(P<0.05)。(4)抑郁与IL-6、犬尿氨酸呈显著正相关性(r=0.351,P=0.021;r=0.256,P=0.002),焦虑与Scr、BUN呈显著正相关性(r=0.152,P=0.034;r=0.689,P=0.016)。结论炎性因子诱导使维持性血液透析患者色氨酸代谢成犬尿氨酸,中枢内5-HT水平降低,促使患者出现抑郁和焦虑等负面心理情绪,且抑郁与IL-6、犬尿氨酸水平呈显著正相关性,焦虑与Scr、BUN水平呈显著正相关性。Objective To study and analyze the psychological and mental state of patients with maintenance hemodialy- sis and its correlation with serum tryptophan levels. Methods A total of 122 patients undergoing maintenance hemodialysis from March 2015 to December 2016 in our hospital and 115 healthy volunteers were selected as the study subjects. 122 patients with maintenance hemodialysis were included in the study group, and 115 healthy volunteers were included in the control group. The psychological status of anxiety and depression and serum tryptophan levels in two groups were detected. Results （1）The incidence of anxiety-positive and depression-positive in the study group was higher than that in the control group（P〈0.05）. （2）The levels of IL-6 and kynurenine in the depression group were higher than those in the non-depression group, while Trp and HGB in the depression group were lower than those in non-de- pression group（P〈0.05）. （3）The levels of Scr and BUN in the anxiety group were higher than those in non-anxiety group. The levels of serum calcium and phosphorus in the anxiety group were lower than those in the non-anxiety group（P〈 0.05）. （4）There was a significant positive correlation between depression and IL-6 and kynurenine（r=0.351, P=0.021; r=0.256, P=0.002）, and there was a significant positive correlation between anxiety and Scr and BUN（r=0.152, P=0.034; r=0.689, P=0.016）. Conclusion Inflammatory factors induce tryptophan metabolism into kynurenine in the patients un- dergoing maintenance hemodialysis. Central 5-HT level is decreased, inducing depression and anxiety and other nega- tive emotions in patients. Depression and IL-6 and kynurenine levels are significantly positively correlated, and anxiety and SCr and BUN levels are significantly positively correlated.

关 键 词：维持性血液透析 心理状况 血清色氨酸水平 相关性 

分 类 号：R692.5[医药卫生—泌尿科学] R749.4[医药卫生—外科学]